Chapter 34 Abrams FVE

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A client is receiving hydrochlorothiazide. The nurse would expect this drug to begin acting within which time frame?

2 hours

You are monitoring serum electrolyte levels in a 55-year-old patient who has been prescribed digoxin and a potassium-sparing diuretic for treatment of heart failure. Which of the following potassium levels would you hope to see for this patient?

4.0 mEq/L

The students are discussing the electrolytes in the body. What should the students know has the greatest influence on potassium loss from the body?

Aldosterone

You have been prescribed HydroDIURIL. What will the nurse tell you is considered a contraindication to the administration of hydrochlorothiazide (HydroDIURIL)?

Allergy to sulfa drugs

Where is the majority of potassium that is filtered at the glomerulus reabsorbed?

Bowman's capsule

Much of the sodium in the filtrate is reabsorbed in the proximal convoluted tubule to the peritubular capillaries. As the sodium is moved out of the filtrate, what does it take with it?

Chloride ions

How does the renal system maintain the volume and composition of body fluids within normal ranges? Select all that apply

Clearing nitrogen waste by-products Maintaining acid-base levels Stabilizing electrolyte levels Excreting drug metabolites

A client who has been taking hydrochlorothiazide arrives at the clinic for his 1-month follow-up appointment. The client tells the nurse that he feels weaker since he began taking the drug. What should the nurse consider as a possible cause of these symptoms?

Hypokalemia

Ms. Crampton is prescribed furosemide for chronic heart failure. The nurse knows that furosemide can cause electrolyte imbalances and what other serious side effect?

Metabolic alkalosis

A male client has cirrhosis and is receiving diuretic therapy. The nurse knows that what drug will help prevent metabolic alkalosis or hypokalemia in this client?

Spironolactone

Why would potassium-sparing diuretics be contraindicated for clients experiencing renal failure?

They may cause hyperkalemia.

Which substances are moved from the glomerulus into the tubule due to hydrostatic pressure?

Water

A nurse understands that loop diuretics are considered high ceiling diuretics because they:

cause a greater diuresis.

Which diuretic will most likely be the initial drug of choice when a client demonstrates dyspnea related to pulmonary edema?

furosemide

A patient with a longstanding diagnosis of chronic renal failure has experienced a significant decline in urine output in recent days, prompting him to seek care at a local clinic. A nurse at the clinic has suggested to a colleague that the administration of a diuretic such as hydrochlorothiazide may improve the patient's urine output. How should the colleague best respond to this suggestion?

"Actually, patients with renal failure usually can't take hydrochlorothiazide."

The nurse, who works in the emergency department, is aware that the renin-angiotensin-aldosterone system works to maintain blood flow in the kidneys. What vital sign would signify the initiation of this system in a trauma client?

Decreased blood pressure

Diuretics increase the production and output of urine. Which statement helps explain how diuretics achieve these effects?

Diuretics reduce the reabsorption of water in the kidneys.

The nurse is evaluating an 82-year-old client's medical record. The client is receiving hydrochlorothiazide. What abnormal laboratory result is related to the medication?

Elevated uric acid levels


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